Topics Related to Medicaid Managed Care

NC Medicaid updates mental health and substance use disorder policies.
Effective Feb. 1, 2025, Clinical Coverage Policy 10A services for beneficiaries aged 21 and older may be provided by independent practitioner providers.
The implementation of the Rate Reimbursement Methodology for individuals living in congregate settings will take effect on April 1, 2025.
Effective Jan. 1, 2025, NC Medicaid will cover U.S. Food & Drug Administration approved cell and gene therapies
Children with NC Medicaid temporarily living in another state can get a free Vaccine for Children (VFC) vaccine from any VFC provider in that state.
This is an update to the September 2016 Medicaid Ordering, Prescribing or Referring Special Bulletin.
This bulletin has updated end dates & additional flexibilities for Behavioral Health, Care Management, Innovations, and Long-Term Services & Supports.

This bulletin applies to NC Medicaid Direct and NC Medicaid Managed Care. 

Comments accepted through Jan. 6, 2024.
NC Medicaid will continue the current Tailored Care Management temporary payment rate of $343.97 statewide through June 30, 2025.